ABSTRACT

This introduction presents an overview of the key concepts discussed in this book. The book highlights the key issues surrounding the provision of outreach services and to open up the debate for the future. The introduction of general practice fundholding in April 1991 led to the emergence of many new specialist outreach clinics in general practices. The shifted outpatient model appears to best describe the specialist outreach clinics established in fundholding practices since the introduction of fundholding in April 1991. Specialist outreach clinics established since the introduction of fundholding have gone largely unevaluated. This is despite their importance as one of the most significant innovations that a major shift in government policy, GP fundholding, has produced and despite the commonly expressed concern about their impact on equity of access to outpatient services. This dearth of research evidence is also true of fundholding in general.